Association of body mass index with the outcomes of retrograde intrarenal surgery

V. Selmi, Sercan Sarı, M. Cakici, H. Özdemir, I. Kartal, M. A. İmamoğlu
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Abstract

Objective: Overweight and obesity increased worldwide over four decades. In 2016, nearly 11% of men and 15% of women over 18 years old were obese. Obesity is accepted as a risk factor for renal stones. The relationship between obesity and urolithiasis is complicated. Various complications can occur during perioperative or postoperative follow-up in obese patients. Minimal invasive nature and high efficacy of Retrograde Intrarenal Surgery (RIRS) present itself as a safe and less morbid treatment option. In this study, we aimed to compare the efficacy and safety of RIRS in the treatment of kidney stones in different BMI levels. Material and Methods: Files of 552 patients who underwent RIRS for renal stones between January 2012 and December 2017 were reviewed. We classified patients according to the World Health Organisation classification. These three groups were compared for stone-free rate, complication rate, operative and fluoroscopy times and length of hospital stay. Results: The stone-free rate (SFR) of the study population was 80.8%. It was 81% for Group 1, 83.7% for Group 2 and 77.7% for Group 3. There was no statistically significant difference between the three groups among SFR (p=0.346). Clinical insignificant residual fragments (CIRF) status was also similar among the three groups (p=0.254). Complication rates between the three groups were statistically similar (p=0.416). Conclusion: In this study, we have shown that RIRS is a suitable option for all urolithiasis patients, even for obese individuals. Stone-free rates, length of hospital stay, operation time and complication rates in obese patients are similar with non-obese patients. Keywords: urolithiasis; obesity; laser lithotripsy
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身体质量指数与逆行肾内手术结果的关系
目的:在过去的40年里,超重和肥胖在世界范围内有所增加。2016年,近11%的18岁以上男性和15%的18岁以上女性肥胖。肥胖被认为是肾结石的一个危险因素。肥胖与尿石症之间的关系是复杂的。肥胖患者围手术期或术后随访可出现各种并发症。逆行肾内手术(RIRS)具有微创、高效的特点,是一种安全、发病率低的治疗方法。在本研究中,我们旨在比较RIRS治疗不同BMI水平肾结石的疗效和安全性。材料与方法:回顾2012年1月至2017年12月期间552例因肾结石接受RIRS治疗的患者的档案。我们根据世界卫生组织的分类对病人进行分类。比较三组结石无结石率、并发症发生率、手术及透视次数及住院时间。结果:研究人群无结石率(SFR)为80.8%。1组为81%,2组为83.7%,3组为77.7%。三组间SFR差异无统计学意义(p=0.346)。临床不显著残留碎片(CIRF)状况在三组之间也相似(p=0.254)。三组并发症发生率比较,差异有统计学意义(p=0.416)。结论:在这项研究中,我们已经表明RIRS是所有尿石症患者的合适选择,甚至对于肥胖个体也是如此。肥胖患者的结石清除率、住院时间、手术时间和并发症发生率与非肥胖患者相似。关键词:尿石病;肥胖;激光碎石术
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